What are the conservative treatments for acromioclavicular dislocation?

Acromioclavicular joint dislocation is relatively common in clinical practice and is a form of trauma. It is usually caused by accidental collisions and falls during daily exercise or work. It is actually not difficult to treat and there are many methods. However, the specific method to be chosen depends on the patient's specific situation. Conservative treatment should be the treatment method chosen by most people. Let's take a look at the conservative treatments for acromioclavicular joint dislocation.

1. Conservative treatment

For type I acromioclavicular dislocation, rest and sling with a triangular bandage for 1 to 2 weeks is sufficient; for type II dislocation, a sling can be used for fixation. The method is that the patient stands with both upper limbs raised high, and a plaster apron is put on first, with the upper edge at the same level as the nipple plane and the lower edge to slightly below the anterior superior iliac spine. An iron buckle is installed on the front and back of the apron. After the plaster is completely dry, a piece of thick felt is placed on the raised part of the outer end of the clavicle (do not place it on the acromion). Another 3-5 cm wide belt-type canvas belt is used to pass over the thick felt placed on the affected shoulder, and the two ends of the belt are tied to the iron buckles on the front and back of the plaster apron. Tighten it with appropriate force to compress and reposition the separated outer end of the clavicle. Take an X-ray to confirm reduction, wrap the injured limb with a triangular bandage, and fix it for 4 to 6 weeks. It can also be reduced under local anesthesia, with Kirschner wires cross-fixed from the distal end of the clavicle through the acromioclavicular joint and the acromion. The affected limb was suspended after the operation, the steel needle was removed after 6 weeks, and shoulder joint functional exercises were performed.

2. Surgical treatment

For patients with total dislocation of the acromioclavicular joint, i.e. type III injury, the joint capsule, acromioclavicular ligament and coracoclavicular ligament have been ruptured, causing the acromioclavicular joint to completely lose stability. The above-mentioned external fixation effect is unsatisfactory. For patients under the age of 45, surgical repair should be performed. Commonly used surgical methods include open reduction and internal fixation of the acromioclavicular joint, reconstruction or fixation of the coracoclavicular ligament, resection of the lateral end of the clavicle, and muscle dynamic reconstruction.

3. Chronic acromioclavicular dislocation and acromioclavicular subluxation generally have no clinical symptoms and do not require surgical treatment. If there are symptoms such as pain in total dislocation, the following operations can be performed: ① Resection of the outer 1/3 of the clavicle, so that its appearance and function can be satisfactory; ② Transposition of the coracoacromial ligament to replace the coracoclavicular ligament: cut off the scapular end of the coracoacromial ligament, sew this end into the clavicular medullary cavity of the removed end, tighten and ligate; ③ Muscle dynamic transposition: After the acromioclavicular joint is open, reduced and fixed with Kirschner wires, the coracoid process is cut off from its base, and transplanted upward and inward to the clavicle together with the tendon on it, and fixed with screws. The tension of the muscles attached to the coracoid process is used to maintain the position of the clavicle after reduction.